Swaddling
Is it safe to swaddle my baby when he sleeps?
by The Babble Staff
November 27, 2006
To Swaddle or Not To Swaddle?
PRO-SWADDLING
AGAINST SWADDLING
THE BABBLE TAKE
Swaddling was once relegated to the category of discredited child-care practices, thought of as old-fashioned and possibly harmful. Now, with the advent of theories about "the fourth trimester," swaddling — wrapping your baby, burrito-style, in a blanket — suddenly seems edgy and new. Swaddling advocates wax poetic about the "womb-like experience" and ancient wisdom. Swaddling, they say, makes babies feel safe and cared for; this, in turn, makes them less likely to flail and throw self-perpetuating crying fits, and more likely to sleep happily through the night. A physician at St. Louis Doctors' Hospital, Brad Thach, conducted a study on reluctant back-sleepers whose insomnia was cured by swaddling; he posits that swaddling may help prevent SIDS. But not everybody is as enthusiastic. Some claim that crying and flailing might not be bad and that babies need to have freedom of movement. One medical study has shown possible links between widespread swaddling in Turkey and China and the high rates of infant pneumonia in those countries. The authors of the study think that the combination of swaddling and lying on their backs might have adverse effects on the respiratory system. Too much swaddling has also been linked to hip displacement and other joint problems.
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PRO: Dr. Harvey Karp, excerpt from The Happiest Baby on the Block
Soothing an irritable infant is one hundred times easier when her hands are snuggled straight at her sides. Why does this work so well? Not only does swaddling feel cozy, it also keeps your baby from whacking herself and inadvertently getting more upset. (You may have noticed how much calmer your baby is when she is "wrapped" in your arms.) Before birth, your uterus kept your baby's arms from spinning like a windmill. After her "eviction," this restriction disappears. Without the womb walls to prevent flailing, your baby's small upsets can quickly switch on her Moro reflex (the falling reflex) and start her thrashing and crying.
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Soothing an irritable infant is one hundred times easier when her hands are snuggled straight at her sides. Why does this work so well? Not only does swaddling feel cozy, it also keeps your baby from whacking herself and inadvertently getting more upset. (You may have noticed how much calmer your baby is when she is "wrapped" in your arms.) Before birth, your uterus kept your baby's arms from spinning like a windmill. After her "eviction," this restriction disappears. Without the womb walls to prevent flailing, your baby's small upsets can quickly switch on her Moro reflex (the falling reflex) and start her thrashing and crying.
When your baby is crying, she experiences a sensation similar to ten radios playing in her head — at the same time. Each jerk and startle shoots another alarm message to her brain, and together those signals make such a racket that your crying infant may hardly notice you're there! Your little screamer desperately needs you to tell her, "That's it, I'm taking over now." And that's exactly what swaddling does. By restraining your baby's movements, you turn off most of the distracting "radio stations" so she can tune in and focus on all the wonderful things you're doing to soothe her. Wrapping also prevents new twitches from igniting the crying all over again.
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PRO: Dr. Greene "Swaddling and Sleep"
On average, the babies did indeed sleep significantly better for the half of the night that they were swaddled. The swaddled babies spent significantly more total time asleep. They had fewer spontaneous awakenings. When the swaddled babies did wake up (which we all do, several times each night), they fell back asleep in an average of only 30 seconds (ranging between 0 and 7 minutes). The heart rates of the swaddled infants were also more responsive (a good thing!). There was no change in core temperature or oxygen saturation. Nevertheless, the swaddled babies awakened more easily to outside noises! Perhaps this increased responsiveness to the outside environment makes SIDS less likely.
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SWADDLING: BabyCenter® "What Is 'Swaddling'? What are the pros and cons?"
Swaddling is an age-old technique for keeping an infant warm and secure. To swaddle your baby, spread a receiving blanket out flat, with one corner folded over. Lay your baby face-up on the blanket, with his head resting on the folded corner. Wrap the left corner over his body and tuck it beneath him. Bring the bottom corner up over his feet, and then wrap the right corner around him, leaving only his head and neck exposed. Don't cover your baby's face with the blanket, since that could overheat or suffocate him. And make sure you don't wrap your baby too tightly, or his circulation could be cut off.
Swaddling creates a slight pressure around your baby's body that gives most newborns a sense of security. A newborn may even sleep better when swaddled because he's less likely to jerk awake when he startles. Some babies, though, don't enjoy being swaddled.
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Preliminary evidence on the possibility that swaddling may interfere with normal respiratory function and thereby predispose to pneumonia was gathered in a teaching health center in Ankara. Babies who had been swaddled for at least three months were four times more likely to have developed pneumonia (confirmed radiologically) and upper respiratory infections than babies who were unswaddled. These preliminary findings were highly significant and are being followed up by further studies.
...read the full article
Preliminary evidence on the possibility that swaddling may interfere with normal respiratory function and thereby predispose to pneumonia was gathered in a teaching health center in Ankara. Babies who had been swaddled for at least three months were four times more likely to have developed pneumonia (confirmed radiologically) and upper respiratory infections than babies who were unswaddled. These preliminary findings were highly significant and are being followed up by further studies.
Pneumonia and a history of at least two upper respiratory infections were each about four times more common in swaddled than unswaddled babies.
It may be that a combination of swaddling and the supine position produces the greatest effect on respiratory ventilation. Rickets was more common in swaddled babies than in unswaddled babies presumably because of lack of exposure to sunlight. In Israel, Block reported an association between swaddling and congenital dislocation of the hip and similar results were reported among Navajo babies bound to cradle boards. No such association was found in this series of cases. The extremely high mortality and morbidity from neonatal and infant pneumonia in China and Turkey is being further investigated by prospective studies which will provide more precise information on time relationships between swaddling and pneumonia.
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CON: Dr. Sears, excerpt from The Baby Book
Shorten swaddling time. Once upon a time, wrapping babies burrito-style in a blanket was advised to help them settle easier. New insights, however, have shown that swaddling babies too often and for too long may harm their hip development. In order for the ball-and-socket structures of the hip joint to develop properly, babies need to have freely swinging motion of their legs and lie or sleep with their legs outward in a frog position. Leaving their legs unbound is especially crucial in the first few months, when the hip joint is rapidly developing. Swaddling your baby for a few hours every few days won't harm her hip development, but avoid letting her sleep tightly swaddled for long periods of time, such as through the night.
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